The Health and Well-Being of the Left-Behind Elderly in Rural China

Abstract

The elderly in rural areas of China whose children have migrated to urban areas for employment have been labelled the “left-behind” elderly. Given inadequate support from the government, it is expected that elderly parents will turn to their families for physical, financial, and psychological assistance. However, rural adult-child migration has eroded traditional family support and led to the presence of millions of left-behind elderly parents in rural areas. The creation of the overwhelming number of left-behind elderly in rural China, some of whom are incapable of fully caring for themselves, has been an outcome of a confluence of social and demographic changes instituted by the Chinese government, including wealth inequality, rapid urbanization, the hukou and rural pension systems, the one-child policy and the adoption of neoliberalism. The health impacts of the migration of adult children on left-behind elderly have been both positive and negative. Deleterious impacts on health include: increased likelihood of suffering a serious fall and reporting poorer self-rated health and activities of daily living; feelings of powerlessness and poor memory; and lower levels of happiness and significantly higher levels of loneliness and depressive symptoms. However, the increased income resulting from child migrant labour remittances has improved their elderly parents’ ability to afford a healthier diet, experience less stress, and have better financial access to quality medical care. These nuanced and contradictory impacts of migration on the health of left-behind elders may also be affected by the number of children migrated; who has migrated and for how long; changes in elders workload and vulnerability; the quality, capability, and accessibility of rural healthcare; differences in the vulnerability of left-behind elders; and differences in elders agency, recuperation, social cohesion, and social capital. Although individual assets and capabilities of elders benefit from reinforcement, the prioritization of developing social infrastructure that protects the health and well-being of the rural left-behind elderly in China is essential to ameliorate the impacts of years of the PRC’s policies that have exacerbated the vulnerability of the rural elderly.